Morbidity and survival after bronchoplastic surgery for non-small-cell lung cancer.

BACKGROUND: Bronchoplastic procedures are an accepted surgical approach in patients with resectable non-small-cell lung cancer (NSCLC) to avoid pneumonectomy. Post-operative complications associated with the bronchial anastomosis and local recurrence of the tumor have to be considered. Experimental design and setting: Retrospective analysis of the clinical courses and follow-up of 1,610 consecutive patients who received surgical resection for NSCLC at the Department of Surgery, Klinikum Grosshadern, University of Munich, Germany. Among them there were 134 (8.3%) bronchoplastic resections. METHODS: Morbidity, mortality, and survival rate were investigated in these patients to verify the safety of this technique. RESULTS: From all 134 bronchoplastic resections, 105 lobectomies, 22 bilobectomies, and 7 pneumonectumies were performed. Atelectasis was observed in 6.0% (versus conventional procedures: 3.7%; p: n.s.), whereas anastomotic dehiscence occurred in 3.0%. In-hospital mortality amounted to 3.7% (versus 5.3%; p: n.s.). The stage dependent 5-year survival in R0-resected patients was comparable in both groups. CONCLUSIONS: Our results demonstrate that bronchoplastic procedures represent a safe therapeutic option in the operative treatment of non-small-cell lung cancer that should be considered in all patients with central tumor growth.